Electronic Newsletter

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September 10, 2004, Issue No. 146

AHRQ News and Numbers

Among both non-elderly and elderly people with expenses for doctors' visits and/or other ambulatory care, residents of rural counties on average had the fewest visits (approximately five) and lowest expenses ($609 for non-elderly, $662 for elderly) per year. Among those with expenses for prescription medicines, the average annual expense among people in rural areas was not significantly different from that for people in other types of counties. [Source: Agency for Healthcare Research and Quality, MEPS Chartbook No. 13, Health Care in Urban and Rural Areas, Combined Years 1998-2000.]

1. Oral Erythromycin Combined With a Number of Commonly Used Drugs May Increase the Risk of Sudden Death From Cardiac Causes

Patients who took the antibiotic erythromycin with medications that inhibit CYP3A drug enzymes, such as certain calcium-channel blockers, certain antifungal drugs, and some antidepressants, had a five-times greater risk of sudden death from cardiac causes than patients who did not take the drugs at the same time. Erythromycin is a commonly used antibiotic because it is considered to be inexpensive and very safe. In the study, which is published in the September 9 issue of the New England Journal of Medicine, Wayne A. Ray, Ph.D., and his colleagues at AHRQ's Centers for Education and Research on Therapeutics (CERTs) at Vanderbilt University, did not find the same increased risk for patients who took CYP3A inhibitors with other antibiotics such as amoxicillin or for those who had taken erythromycin in the past. Select to read our press release.

2. New Study Estimates That Some Pregnant Women Are Prescribed Drugs Which May Be Considered Unsafe During Pregnancy

Nearly half of pregnant women who had received medications other than vitamins may be taking drugs that the FDA classifies as having no human evidence of safety for use during pregnancy or that evidence has shown can harm a developing fetus. The study, the largest to date to examine the prescription drug use of women during pregnancy, was conducted by researchers at AHRQ's HMO Research Network Center for Education and Research on Therapeutics. The study was published in the August 2004 issue of the American Journal of Obstetrics and Gynecology. Select to read our press release and to read the abstract on PubMed®.

AHRQ has revised and improved its interactive clinical decision-support tool for personal digital assistants (PDAs) that was originally released in April. The Electronic Preventive Services Selector (ePSS) is designed to help clinicians deliver evidence-based recommendations from the AHRQ-sponsored U.S. Preventive Services Task Force when they are with a patient. The Electronic Preventive Services Selector (ePSS) helps clinicians quickly and easily search for which preventive services to provide-or not provide-to patients based on their age and gender. Select to download the tool. (This tool works on all Palm and Pocket PC devices on the market at this time.)

4. First Volume of Evidence-based Practice Center Technical Review Series, "Closing the Quality Gap," Is Available

The first volume in a new series of AHRQ Evidence-based Practice Center Technical Reviews, titled Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 1: Series Overview and Methodology (Technical Review 9) is now available. The reports explore the human and organizational factors influencing quality improvement strategies and evaluate nine quality improvement strategies, tools, or processes aimed at reducing the quality gap. The first in the series outlines the challenges to translating research into clinical practice and the methodologies used in the report. Select to access Volume 1 or send an E-mail to AHRQPubs@ahrq.hhs.gov. Volumes 2 and 3 will focus on improving the treatment of patients suffering from diabetes and hypertension, respectively, and will be available soon.

5. AHRQ Study Found Savings in Vaccinations for Chickenpox

Vaccinating children against chickenpox saves the American health care system nearly $100 million a year in reduced hospitalizations for severe cases, according to a new study. Although most people who get chickenpox can be treated at home, complications requiring hospitalization can include severe skin infections, encephalitis, and pneumonia. Routine vaccination has reduced cases in young children who receive the shots and has helped keep the disease from spreading to unvaccinated older children and adults, in whom the disease tends to be more severe. The study, which was published in the September issue of Pediatrics, used AHRQ data from the Nationwide Inpatient Sample to examine hospitalization patterns and hospital charges for 1993-2001. Select to read the abstract on PubMed®.

The NQF and JCAHO have announced the 2004 recipients of the annual John M. Eisenberg Patient Safety and Quality Awards. The honorees, by award category, were for Individual Achievement: Lucian Leape, M.D., Harvard School of Public Health, Boston, MA; Research Achievement: Peter Pronovost, M.D., Ph.D., Johns Hopkins University School of Medicine, Baltimore, MD; Innovation in Patient Safety and Quality at a National or Regional Level: Kaveh G. Shojania, M.D., and Robert M. Wachter, M.D., University of California, San Francisco, CA; and Major Danny Jaghab, Booke Army Medical Center, San Antonio, TX; and Innovation in Patient Safety and Quality at a Local or Organization Level: University of Pittsburgh Medical Center, McKeesport, PA.

7. New National Guideline Clearinghouse™ CD-ROM Tutorial Now Available

AHRQ's National Guideline Clearinghouse™ (NGC) announces the availability of a new CD-ROM tutorial of its enhanced Web site. The tutorial walks users through a series of informative demonstrations and scenarios on how to use the enhanced NGC Web site—a comprehensive database of over 1,300 evidence-based clinical practice guidelines and related documents that is currently used by physicians, nurses, and other health care professionals to access objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use. A free copy of this tutorial is available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.

8. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.